Many Michigan older adults are having a ball, but a surprising number of the state’s over-50 population is struggling with a lack of health care, too few home and community-based services and other challenges.

These findings, based on research by AARP Michigan and Western Michigan University College of Health and Human Services, along with help from 19 other state organizations, were released at an AARP conference in Lansing earlier this week.

The entities looked at scores of data and came up with tangible ways to help resolve the issues and make the state a more senior-friendly place.

The nine-month study, called “Disrupting Disparities: A Continuum of Care for Michiganders 50 and Older,” proposes a coordinated care network, maintaining Healthy Michigan Medicaid expansion, extending broadband internet to every corner of the state, and implementing a Family Caregiver Tax Credit. The tax credit would help middle-class Michigan residents afford the financial challenges of family caregiving.

More than 200 people attended the event, including many seniors from throughout Michigan who rode in buses to the conference and had an opportunity to question conference leaders.

The report stressed that the state must take steps to close health care access disparities related to race, geography and income.

Key findings

The research report produced key findings to be addressed. Among them:

Health disparities in Michigan that start at birth and continue into adulthood affect the lives of millions of health care consumers in racial and ethnic groups, reported a 2018 W. K. Kellogg Foundation study. Eliminating the disparities could boost the state’s economy by $4.1 billion.

African-American seniors in Michigan fare worse than their white counterparts on several health indicators. The indicators include lower rates of health insurance coverage, more unmet household and personal care needs, higher rates of diabetes and high blood pressure, a higher likelihood of skipping medical care, and lower use of online health care services.

The state falls short on providing sufficient home and community-based services for older adults and people living with physical disabilities.

Family members are the primary caregivers for older adults. The total estimated economic value of the uncompensated care they provide is roughly $14.5 billion a year. The out-of-pocket costs by family caregivers is nearly $7,000 a year. For Hispanic/Latino caregivers, the cost is $9,000. African-American family caregivers spend nearly 34 percent of their income on caregiving.

Telehealth is seen as a viable solution to getting health care to older adults throughout the state. About a third of the seniors surveyed by AARP are interested in using it. Thirty-nine percent would be interested in using remote patient monitoring to track and send important health information to a provider.

Telehealth has barriers, though. They include lack of understanding about it, privacy concerns, scant computer skills among some seniors, and fear that telehealth might eliminate an in-person visit with a doctor.

“Trust me, not everyone is having a good time, and minorities have fared far worse,” Alicia Georges, national volunteer president of AARP, told the crowd. “And trust me, these gaps are nationwide.”

Michigan is one of the most rapidly aging states in the nation. Its residents age 65 and older comprise 15 percent of the population; by 2050 that number is expected to be at 22 percent.

“This (research) was to look at disparities and what gaps exist and how to close them,” said Elaine Ryan, AARP vice president of government affairs in Washington, D.C. “Every place is different. In Michigan, 90 percent of (older) people want to live in their own home. But there is a mismatch between people who need services and people getting them.”

Ryan added that nursing care in Michigan costs about $11,000 a month. “We are looking at the business case and see it is less expensive to care for people at home.”

She said she was surprised that 44 percent of older Michigan residents live alone, which can result in social isolation. Such isolation can cause depression, result in fewer doctor visits and more trips to the emergency room. Telehealth (a video call with a health care provider or specialist) would help reverse these trends, she said.

Governor candidates weigh in

Michigan’s gubernatorial candidates weighed in via video during the conference, focusing on the importance of internet access throughout the state. Conference speakers stressed that the next governor would be tasked with making many of the study’s initiatives a reality.

“We need to expand issues like telemedicine and broadband to assist people in more rural areas so they can have adequate and top-flight health care, and get connected as well,” said Republican nominee Bill Schuette. “Healthy Michigan (Medicaid expansion) is the law, and it’s not going anywhere.”

Democratic nominee Gretchen Whitmer called internet access “a critical issue that means quality of life for seniors. I want to get everyone in Michigan connected.

“Ensuring that Michigan is a great place to retire is really important. We want to keep seniors here and thriving in this state. Access to health care is a critical piece of that.”

Research yields recommended calls to action

An economic analysis by Public Sector Consultants helped determine the report’s recommended calls to action. The 19 partner organizations, including the Michigan Department of Civil Rights, the Michigan Nonprofit Association and American Indian Health & Family Services, also contributed.

“They were with us from the beginning, sharing ideas and information at the roundtables, providing invaluable perspectives, and adding encouragement and enthusiasm along the way,” Paula Cunningham, AARP Michigan state director, stated in the report.

The calls to action focus on these areas: chronic disease, home and community long-term services and telehealth and broadband internet.

The Public Sector Consultants analysis found:

• “If Michigan can reduce the prevalence of diabetes among the senior population (65+) by 1 percent, it could decrease treatment costs by over $32.5 million.”

• “If Michigan can delay entrance for 1 percent of the 38,801 Medicaid recipients currently in certified nursing care for one year and keep them on aged/disabled 1915(c) waivers, the state could save $3.15 million in general fund Medicaid expenditures. By doing so, the savings would allow the state to serve an additional 722 people through other home and community-based services.

• “An estimated 368,000 rural Michigan households do not have access to broadband internet. As a result, just over $2.5 billion in potential economic benefit is left unrealized among disconnected households. Rural Michigan residents and their caregivers who do not have adequate access to telemedicine options spend an additional $5,262 in travel expenses and lose $2,314 in wages.”